A Simulation-Based Robotic Curriculum for General Surgery Residents

Introduction: Robotic surgery has grown exponentially over the past several years and has expanded across several surgical specialties.1 With the rapid rise in robotic surgery, an effective, standardized, and validated robotic surgery training curriculum for general surgery residents is required.2,3 The aim of this video is to demonstrate the feasibility of a curriculum to provide a standardized training program in robotic surgery for the new generation of surgeons. Materials and Methods: This is a 2-week robotic training curriculum instituted by the University of Chicago General Surgery Residency Program. The robotic training rotation was offered to every postgraduate year 3 general surgery resident. The curriculum involved training on virtual reality simulations that included 23 exercises using The da Vinci®Skills Simulator (DVSS) and SimNow®, inanimate drills including inguinal and ventral hernia repair, suturing, biotissue exercises including interrupted hepaticojejunostomy, running hepaticojejunostomy, gastrojejunostomy, and pancreaticojejunostomy, operating room (OR) observations, and mentored sessions with surgical faculty highly trained on the robot. All drills were recorded and timed, and residents' performances were graded using the Objective Structured Assessment Technical Skills (OSATS). After the completion of the curriculum, residents received clearance to use the robot in the OR and completed a robotic case under supervision as console surgeon, usually performing a cholecystectomy. Results: Twenty-three residents completed the curriculum. Residents improved both their time and performance (OSATS score) when comparing the first attempt with their fourth attempt. After completion of the curriculum, all residents were effective in performing a robotic cholecystectomy under supervision without any eventful complications. Conclusion: Residents' robotic skills, as demonstrated by time and performance, improved upon completion of the curriculum. Patient safety is paramount, and this curriculum ensures adequate robotic surgical experience before utilizing the console in the OR. This video ultimately provides one example of the effectiveness and feasibility that this curriculum can offer to general surgery resident training. Authors' Contributions: All authors contributed to the concept and approved the submitted version. Disclaimers: No consent form was needed. None of the authors have any competing financial interests. Runtime of video: 9 mins 35 secs